Organization
ORIGEN THERAPY LLC
Active
Organization
ORIGEN THERAPY LLC
Active
Other names
Full Circle LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE BURNS LCSW (OWNER)
(505) 919-9734
Entity
Organization
Contact information
Practice address
826 CAMINO DE MONTE REY, SUITE A6, SANTA FE, NM 87505
(505) 988-8010
Mailing address
PO BOX 32526, SANTA FE, NM 87594-2526
(505) 919-9734
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
N/A
—
Enumeration date
05/06/2022
Last updated
10/10/2023
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